House Check – Patriot RECC

Going on vacation? Work trip? Going to be away from home? Fill out the form below and have a designated officer check on your home while you’re away. This form is for the communities of Ashby, Dunstable, Groton, Pepperell, and Townsend.

Name

First Last

Phone

Address

Street Address City State ZIP Code

Departure Date

Return Date

Lights Left On?

Yes

Alarm in Residence?

Yes

Vehicle in Driveway

Vehicle #2 in Driveway

Anyone accessing your home while you are away?

Yes

If yes, who?

If yes, who? (continued)

Emergency Contact Name

Emergency Contact Phone

Emergency Contact #2 Name (If Applicable)

Emergency Contact #2 Phone

Additional Information